Brazilian version of the Jefferson Scale of Empathy: psychometric properties and factor analysis

Background: Empathy is a central characteristic of medical professionalism and has recently gained attention in medical education research. The Jefferson Scale of Empathy is the most commonly used measure of empathy worldwide, and to date it has been translated in 39 languages. This study aimed to adapt the Jefferson Scale of Empathy to the Brazilian culture and to test its reliability and validity among Brazilian medical students. Methods: The Portuguese version of the Jefferson Scale of Empathy was adapted to Brazil using back-translation techniques. This version was pretested among 39 fifth-year medical students in September 2010. During the final fifth-and sixth-year Objective Structured Clinical Examination (October 2011), 319 students were invited to respond to the scale anonymously. Cronbach's alpha, exploratory factor analysis, item-total correlation, and gender comparisons were performed to check the reliability and validity of the scale. Results: The student response rate was 93.7% (299 students). Cronbach's coefficient for the scale was 0.84. A principal component analysis confirmed the construct validity of the scale for three main factors: Compassionate Care (first factor), Ability to Stand in the Patient's Shoes (second factor), and Perspective Taking (third factor). Gender comparisons did not reveal differences in the scores between female and male students. Conclusions: The adapted Brazilian version of the Jefferson Scale of Empathy proved to be a valid, reliable instrument for use in national and cross-cultural studies in medical education.